Individual
MS. I PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
24920 104TH AVE SE, KENT, WA 98030-6443
(425) 690-3544
(425) 690-9444
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60940426
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2124259
—
WA
Enumeration date
02/27/2019
Last updated
05/08/2020
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